On not being a dietitian.

Just a note – this is a post directed at systemic issues, and specifically the way my field is structured, and is not at all a complaint about the work I do currently, which I love, or about my readers and clients, whom I also love. It’s also an explanation of sorts for the media, who often mistake me for a dietitian.

Many of my fellow dietetics students have expressed similar frustrations. If you don’t live in Ontario, AND you want to tell me to just get over it already and do an internship, since it’s so easy, then please don’t bother commenting. Something like 66% of students who apply for an internship in Ontario this year will not get one, since there are simply not enough spaces. Internship is not included as a part of our degree program, nor is there financial aid available for doing one. It is expected that a person will be in a position to not work for a year in order to afford an internship. I am not.

I am also not expecting to be given an RD credential simply for getting my degree and having some experience – not at all. I believe internship is crucially important – I just also believe that dietetics students in my area have been neglected and forced into a ridiculous bottle-neck that will leave many of them hanging if they don’t happen to be one of the lucky ones. I may very well do an internship when I am able to do so – but when I was graduating, I had a lot of feelings about it, and I wrote them down here. This is not meant as a personal affront to all dietitians everywhere.

I know it’s confusing, since I have an accredited degree in dietetics, I’m a member of Dietitians of Canada (and formerly of the American Dietetic Association too, but they sent me too much crap in the mail from food and diet companies), I’ve received extra training through DC- and ADA-approved workshops, I’ve attended honest-to-goodness dietetic conferences, and I’ve worked in legit hospitals doing legit clinical nutrition stuff.

But, still, I’m not a dietitian – and I use the generic, mostly meaningless term “nutritionist” to describe myself.

What I am is someone who teaches people about normal, healthy eating.

I teach people to give themselves permission to enjoy food and eat enough to feel satisfied, to have regular, reliable meals, to find out which foods help them to feel good, to pay attention when they eat so that they can enjoy it and learn from it, and to learn to value healthy eating in its own right, because it feels good and makes one’s life better, without it being contingent on weight loss.

Sometimes my clients, people who want to learn the basics of normal eating, also have diseases with a nutritional component – diabetes, celiac disease, high cholesterol, etc. And I don’t refuse to work with people who have diseases, provided they receive diagnosis, support, and treatment for that disease from a qualified professional – who isn’t me. Because I don’t practice clinical nutrition.

In October I graduated with a science degree that, without the attached RD behind my name, is essentially worthless in my field. I have spent the last nine years not only learning about nutrition at an accredited school, but working in nutrition at various hospitals, and, according to the way the profession is set up in Ontario, I have achieved nothing. I am qualified to do…nothing. Because I have not endured the professional hazing of dietetic internship.

I’m sure you can detect my bitterness.

I am, and always have been, a fan of the scientific method. I believe science is limited in what it can prove, but remains the best way we have to investigate the natural world. Is it perfectly objective? No, but only because it is practiced by hopelessly flawed human beings. But, battered as its practice has been by our nasty little biases, I still love it, and still believe it is the closest we can come to being objective, to learning whatever does exist of universal truth.

I’m a science girl, and a nutritionist in the lay sense of the word. I have a good education, good training, and good experience. The one thing I’m not is a registered dietitian.

When I refer to a dietetic internship as a “hazing,” it’s not because I believe dietitians are mean or evil. In my five years working in various nutrition departments at various hospitals, my bosses have always been dietitians, and I have loved, really loved, them – as people, as practitioners, and as scientists. Because that’s exactly what they are, despite hardly ever being credited as such.

But I’ve also experienced the necessary underbelly of that world. The conveniently gender-, race-, and class-stratified social and professional hierarchies of the clinic. The interpersonal tensions, the brutal systemic limitations. I got my experience, learned what I could learn from the truly remarkable women whose decades of experience made me feel like a tiny speck in a huge, wondrous world; I took my lumps; I jumped through hoops; I got out so I could finish what I started.

Eleven years ago, I decided to study nutrition because I read a passage about normal eating from Ellyn Satter in the book Losing It by Laura Fraser. It was a revelatory answer to the question I’d asked myself – “How should I eat?” – and spent my time and energy searching out, only to find lies, disorder, unscientific thinking, and shameless contortions of logic. I decided then that this – teaching ordinary people to eat normally, based on sound science – was what I wanted to do.

Ellyn Satter was (and is still) a registered dietitian, and I wanted to do what she did – so I set out to become a dietitian and to learn about the science in the answer I’d stumbled upon.

Along the way, I figured out that I may not actually want to be a dietitian, nor did I need to be to do what I’ve wanted to do all along.

So in October, I walked across a stage and took possession of a hard-won piece of paper that made me…nothing. After spending a third of my life and tens of thousands of dollars on this project, I’m no one of consequence to anyone who matters professionally, and may eventually be called a quack and a charlatan because I do a job that hardly anyone in the world does – defending normal eating against the encroachment of a disordered, deeply classist culture, helping ordinary people pick their steps through the muck of anti-intellectual horseshit that is pop nutrition – and I do it audaciously without those two letters, R and D, behind my name.

Because I don’t have the resources, emotionally or financially, to spend a year doing unpaid labour as an intern at the same hospitals that used to pay me by the hour.

I have an education that makes me more qualified than most of the authors who write mass-market diet books – but because I’m not a dietitian, it doesn’t matter. I exist in the gray margins, professionally and scientifically – and our society does not do margins (or shades of gray) very well.

Do I think it’s unfair? Yes. Does it make me angry? Yes. But I accept it for now, because, thankfully, what I do and what I’ve learned still matters a whole lot to me. If you’re reading this, I suspect it matters to you, too.

117 Comments

well if i had the money to pay you to help me learn to eat normally again i would ma’am. i have been bulimic for over 15 years and am actually finally making a go at stopping. the thought occurred to me: i don’t think i have eaten breakfast since like 5th grade…and I’ve been skipping lunch as well since middle school. Registered dietitian or not, it was you and your articles that really led me into a place where i thought i could try actually eating. don’t think that just because you don’t have the letters behind your name, it doesn’t mean you aren’t making a difference.

Thank you, that means a lot to me. Although I think you’d be better off with someone who specializes in eating disorders, because I am truly not trained to treat those disorders – and because those people do exist! Either therapists or RDs, and they tend to be HAES-friendly.

I am currently a nutrition student and am working under a dietitian in a private practice specializing in eating disorders and intuitive/normal eating. She is awesome. Her name is Jennifer Pereira. You can visit her website at http://www.healthylifestylebalance.com. She is located in Arlington, Texas, but does Skype sessions with some clients who are out of state. Definitely schedule a session if you would like to chat with her about your ed. There should be a contact form on the website if you would like her to contact you about scheduling!

Michelle:
The information you provide on this site is outstanding and enjoyable for all that know, understand, and love the art of eating normally! Thank you for providing all that you do! There are not enough people out there that preach normal eating!

I am a dietitian who specializes in eating disorders and would be happy to point you in the right direction for help, depending on where you live. I currently work for the Inner Door Center® located in Royal Oak, MI. Please feel free to check out our website: http://www.innerdoorcenter.com

If you are unable to find help through us, please still contact us and we can help refer you to a place that will help you!

Michelle, I understand this, I truly do, and I believe you are doing worthwhile work. The sad thing is, many people such as me cannot afford to access your services, and because you’re not a RD, can’t use our insurance coverage to offset the cost of those services. I would dearly love to pay you what I know you are worth, but I can’t. And that makes me sad. But I’m always glad to read your writings here.

No, that wouldn’t be allowable. But it’s really not a barrier to continuing to do what I do (except for the cost factor, which is really something I’m working on) – it’s really only a barrier (to me) in the sense that I’ll be considered “illegitimate” by lots of people in the field.

While insurance is pretty picky, reimbursement through a flexible spending plan might be possible, especially if a doctor or RD will write someone a “Go work with Michelle” prescription. The downside of FSAs is that you’re just spending your own money, but at least it’s pre-tax money. (Do they exist in Canada, or are they just a US thing?)

I’m not sure if I’ve heard of people having FSAs in Canada, but maybe? I think I’m spoiled by living there because, even when working in the hospital, I never had to deal with complicated insurance stuff in the single-payer system. It just wasn’t on my radar at all, so it is a big, frightening, scary world to me in general.

I have to say from what I see on this blog, you are very affordable and you charge rates that are consistent with that we charge here in the states for nutrition therapy.

Most insurances do NOT reimburse for nutrition therapy with dietitians unless…
a) you have diabetes or renal disease
b) dietitians have licenses in your state (the state that I work in does NOT have licenses for dietitians for many, many aggravating reasons)

So you all know – at my clinic we charge $125 for initial assessments and $95 for follow ups (US). We have sliding scale pay rates and package deals to help people out, and we will work with people if they have financial difficulties.

Anyway! Just wanted to let you know, Michelle, that your rates seem very fair to me!

I would be interested in what prompted you to write this… I have seen some really nasty and unfair criticism of your work on other blogs and I guess you probably comments and/or emails along the same lines.
For what it’s worth: I come from another scientific discipline with a similar difference between people who got a degree and people who are “registered practitioners, as you know, namely psychology. When I was getting my undergraduate degree, I saw the college counselor regularly in order to help me deal with my personal brand of craziness. She was not a registered therapist (she had the equivalent of an MSc in psychology and was doing her PhD at the time), and yet working with her has been more helpful than any work I have done with a “proper” therapist. Similarly, working with you has been more helpful for me than any nutrition advice I have ever gotten from a registered dietician (although to be fair, I have had only little contact with registered dieticians) and certainly more helpful than anything I have heard from a doctor. And as someone who holds degrees in both, biochemistry and psychology, I think I am qualified enough to judge that your work is indeed in line with or at least never contradicting the part of the scientific evidence that I have looked at which cannot be said of a lot of things that I have heard from therapists, doctors, and to some degree registered dieticians.
Registration is – in principle – a good idea, I think. However, there are problems in the current system here, and it sounds as if the same is true in Canada.

I wrote this originally just before I graduated – because I was thinking about what the graduation really meant for me and my work. I’ve had discussions along these lines with lots of my fellow students, all of whom are up against the same weird system. In Ontario especially, there is a huge bottleneck that occurs between school and internship, because there are not enough placements available for the hundreds of students who want them each year, and so the competition is incredibly fierce, the pressure is very intense, and I worry a lot about how interns in that situation could be vulnerable to exploitation, as well. It’s not a topic that is really considered a friendly thing to talk openly about, but since I am not technically part of that world anyway, I wanted to talk about it.

But what made me publish it was the fact that a media outlet wrongly described me as “a Registered Dietitian” and after correcting them (a thing I’ve had to do several times with several different websites), I thought I should put this up on my site as a full explanation of that.

(As far as nasty criticism goes, I figure if people have an actual criticism they would like me to address, they will come here to address me directly. And they never do, so I don’t worry about it. People are allowed to think mean things about me, and to say mean things about me if they want.)

As far as the nasty criticism goes, I figure if they have an actual criticism they would like me to address, they will come here to comment or email me directly. And they never do, so I don’t worry about it.

All I can say is: You are far wiser than I am in that respect. Maybe one day I manage to get to a similar place, I really hope so.

Not having this two letter credential may have absolutely no consequence–except for the lack of mail and the increased money in your bank account from not paying dues. I, too, have my anti ADA sentiments; primarily, their lack of value to me as an entrepreneur, as they get us into situations (ie Medicare arrangements) that are horrific from a business standpoint. And I have heard more rigid thinking from RDs than from the general public–ughh!

The RD still remains the most qualifying and respected credential in our field–and one we can build on (like becoming a Certified Diabetes Educator); not just because of the educational and hands on experience and the national qualifying exam, but the continuing education mandate.

That said, there are ways to more constructively become an RD–to get the credential (if you should choose to) and not put in the lengthy internship. One can get a Master’s degree with a built in (and much shorter) internship, as I did. And least you choose your course of study while simultaneously gaining hands on experience–much, much needed in this field.

Somehow, though, I suspect you’ll be remarkably successful with or without the RD!

I appreciate your encouragement – and I may or may not go back to school at some point, but right now I’m definitely taking a break from it. The idea of a Master’s degree fills me with dread at this point, haha! There is something called a “self-directed internship,” I hear, however. I have a lot of research and deciding to do over the next three years.

There are definitely problems with the way internships work in a lot of fields. (I’m thinking back on my own student teaching experience.) On the one hand, it’s reasonable that you have to get practical experience and demonstrate competence before you’re actually certified or registered or licensed. On the other, there’s something very messed up about not only working for free, but paying for the privilege.

This is a really big thing that sticks in my craw – here, you don’t get student loans or any sort of insurance or financial help for the internship. Nor can you get your student loan repayment deferred (or at least, this is what I’ve heard from fellow students who’ve gone on to do their internships in Ontario.) Which means that internships are truly only available to people who are privileged in a specific financial way – either they have a partner or parents who can support them financially and keep up on the payments for their student loans.

A lot of the students in my program were adult learners who already had degrees in other fields, and didn’t have family to support them through a year of unpaid labour. So this obviously is the source of a lot of bias in who ends up being a dietitian. I don’t think it’s a coincidence that dietitians mostly fit a very similar demographic mold (white, female, upper-middle class) because, for whatever reason, these are the people who are more likely to get the resources to spend a year doing an unpaid internship.

As a dietitian I appreciated reading this post. I find that even with the RD title dietitians have to work hard to get respect in their work settings from some of the doctors nurses etc who often feel that they themselves are well qualified to provide the same type of services. Some nurses still see RDs as “the food preference” people, and you get referrals that say things like so and so wants snacks or double portions. :) Being a nearly all women profession does not help, the few men in the profession are often the ones writing blogs and being confident about their knowledge and credentials. I really appreciate reading this blog from you as a younger female who is confident in what you have to offer. The RD title would restrict you a bit in what you could say because of the College wanting everyone to parrot the same evidence-based messaging (which again hurts our credibility, Health Canada takes so long to update their recommendations etc). Many RDs are going under the radar to give different messages to people than the standard ones based on our own experience and analysis of the evidence but it’s not usually on a blog, congrats to you.

I find that even with the RD title dietitians have to work hard to get respect in their work settings from some of the doctors nurses etc who often feel that they themselves are well qualified to provide the same type of services. Some nurses still see RDs as “the food preference” people, and you get referrals that say things like so and so wants snacks or double portions. :) Being a nearly all women profession does not help, the few men in the profession are often the ones writing blogs and being confident about their knowledge and credentials.

I completely, totally, utterly agree. The dietitians I’ve worked with, and been taught by at school, are some of the most scientifically intelligent people I’ve ever known. And thank you so much.

The restriction in speaking one’s mind is definitely something I’ve run up against, and totally didn’t include in this post. This came up a lot in a course I took on nutrition communications – we were basically taught that all we were allowed to do publicly (as RDs) was say exactly whatever Health Canada says. And don’t get me wrong, I quite respect Health Canada and the huge amount of research that goes into those recommendations – but I would also like to be allowed to speak for myself, my own experiences, the experiences of my clients, and to critically analyze the role that culture and media plays in those health messages in the first place. And to acknowledge that every message about health, even coming from a government source, is inherently biased.

I’m from the USA and during my internship I was strongly advised to take on the views of the American Dietetic Association… until I finished my internship and passed the RD exam. Once that was done, I could hold my own opinions about things like the new gluten free craze (for people without a gluten sensitivity/allergy) or high fructose corn syrup, irradiation of food, etc. etc. You could very easily NOT get your RD if you deviated from their point of view, but I don’t think you could get your RD taken away from you for stepping outside the box. You’d have to really mess up (kill a patient or something with your recs) or not complete your continuing education credits.

Basically… becoming a RD means a never-ending money suck… I am glad that the ADA requires us to get continuing education because we need it just as much as any other profession that requires it, but there is a lot of money involved in getting those and in keeping our registration!

“parroting evidenced based messages?” It’s evidenced based for a reason… On peer reviewed research… Peer reviewed by people who are properly educated and have done their own research….geez….I hope you arent getting your info from that Trudeau guy or Dr Oz…

Btw, I did my internship, and I was not unpaid labor, it wasn’t hard, and I got paid.

You are being rude. I appreciate your viewpoint and I love to hear from dietitians, so there’s no need to be antagonistic here. We are listening.

I don’t know where you’re at, but not everyone on this site is an American or lives in the US (myself included) – so internship experiences can vary. For me personally, this is a complicated situation and I have a lot of mixed feelings about internship. When I wrote this, I was feeling frustrated and angry – and I know a lot of my fellow dietetics students have felt the same way.

No, seriously, I already had a tremendous amount of respect for what you do and who you are, and that was before I knew that you were doing it not only despite society but also despite the pressures of your discipline, and if I ever move back to Toronto area I am going to buy you a dozen totally platonic and possibly chocolate roses. Cheers from another poor lass trying to figure out how to do the work she wants within a system that only wants to give her a paycheque for doing something else!

Michelle, I’ve been following your blog for about two years. The content and results of your work speak for themselves, and anyone who reads comments around here knows it. I think your position on eating is incredibly intelligent, thoughtful, well articulated and sincere. An “RD” behind your name wouldn’t make you any more insightful, relatable and helpful than I’ve found you to consistently be. I hope your future brings you a wide scope for your work and a good paycheck to boot – you deserve both.

This is becoming more and more of an issue in various fields. People that are not willing or able to jump through increasingly complex hoops and therefor are barred to be professionals… and the world misses out on great, caring and well-educated individuals – mostly in the field of teachers, trainers and therapists. And the more your walk in life is not direct (‘high school->right college-> right profession’), the more difficult it is to get the correct qualification.

It sucks, and the loss is everyone’s.

In the mean time: I have learned tremendous amounts from all those Not A Real Instructors I’ve met, including your blog, and partly because they arrive on those positions through different routes, and do it from a real passion (and not just because they landed in the field and performed the tricks.)

And a diploma does mean something. It first means something for you: you did complete it, so hah, they can’t take that away. It also means something for everyone that actually is interested in making their own assesment of your skill and knowledge. Not in the simplistic ‘diploma=good, else=bad’ but it is part of your whole package of knowledge and experience and as such it matters.

Very true. I’ve also not noticed a difference in the quality of care I get from, say, PT students as opposed to physical therapists who’ve completed their internships. Likewise, I’ve had lousy doctors and awesome PAs (not quite the same because PAs have completed their own form of training and internship, they’re not PA students, but still an indication that the letters after your name don’t magically make you intelligent, skilled, or empathetic if you weren’t before).

Professionals jump thru hoops such as “hands on training,” clinicals, and professional exams for a reason…. For the safety of our patients. Once we get our RD, we still have to do continuing education to keep it…. For the safety of our patients. In the US, you still need to be licensed in many states to claim the title nutritionist whether you are an RD or not.

That’s a valid point. But the hoops that you jump through to prove that you can do a job shouldn’t include doing it without pay for an entire year, particularly if your student loans can’t be deferred during that time. There has to be a way to prove people are qualified without requiring them to have independent means of supporting themselves through a full year of unpaid labor.

If I had to give you a dollar for every time I told someone that “Eat or die” is the only rule for nutrition, I think I could finance your year of an unpaid internship. It’s frustrating that you don’t have letters after your name to make you an “authoritative” voice, but I find your work and your voice to be some of the most useful, meaningful, and power I’ve ever encountered. Thank you.

Haha, I’d at least love to get Time Served for assessing all those three-day food records. And for wearing a hairnet. And for having people treat me like a peon when I worked in food service (though I didn’t have it as bad as the dietary aides, god love ‘em.)

This issue of unpaid internships in many fields is becoming an international issue – the same complaint is being heard across the English speaking world. It’s always been the case that ‘volunteering’ was the way to get into highly sought-after creative fields like film and fashion, but if you worked in other professional fields, you started at a low wage and worked your way up. But the insistence that people work for free is creating a new kind of aristocracy, where the connections your parents have and the ability to fund a year of no income means what your social background is is more important than the skills you bring to the table.

It’s no surprise that Germany, which still has a solid apprenticeship system, where graduates in all fields are apprenticed to a firm for a year as part of their qualifications, has one of the strongest economies in the Western world – it turns out that taking training seriously pays off economically.

Having said that, your voice is so unique and your insights are so cogent and thoughtful, that I predict a stellar future for you.

I found your blog by chance this year and it has been such a comfort to me! I hope to save up and be able to do one of your online sessions next year and quite frankly don’t care that you don’t have two letters after you name. From what I have read I trust what you have to say.

I understand what you are saying though, I didn’t do my degree in the field that I’ve ended up working in. I learnt on the job which I think is just as good if not better.

You well may eventually be called a quack and a charlatan, but so might we all! In the mean time, you are a ray of shining awesome, in a sky of bleak crappiness. How about adding the letters DNE after your name? Defender of Normal Eating.

This post made me cry. I endured a very similar mess, coming from an anthropology undergrad and fighting to take all the classes the ADA required in addition to that… but because I will not move to some other part of the country alone, for at a year, to undergo the official internship process, I am not an RD. I am a DTR, which mostly feels like a backhanded way of keeping me on mailing lists for pricy continuing education workshops. But I digress.

I want to thank you for sharing your knowledge and experience with others. Thank you for making me feel less alone in my angry gray margin. I believe we will rise and accomplish great things even without the endorsement of a certain corporate-owned professional health organization.

And congratulations on the amazing things you’ve already done! You deserve a party!

Hi Rene – solidarity! I totally feel for what you’re going through. One of the profs at my school, and someone I admire greatly, wrote this article about the process of dietetic education, and what may be missing in it. She doesn’t address the internship problem here, directly, but it is something she is concerned with:

I am getting ready to graduate in May in Dietetics and Public Health Nutrition. I really appreciated this post because I’m facing many of the same frustrations and challenges. I have worked hard the last four years to learn and equip myself with the skills and knowledge I will need to help people in the areas of food and nutrition. However, because of the difficulty of the internship requirements, I am not going to get my R.D. anytime soon. Thank you for your voice and inspiration, truly appreciated.

Here in Australia I couldn’t graduate from my B.Social Work without having done 2 three month unpaid internships. I had to take time off from my full time paid position to do those placements. When I started my Masters in Counselling, I ended up transferring to another university so that I didn’t have to do another 3 month unpaid internship. I would have had to move away from my family to secure that internship because there was no one with my geographical region that had the qualifications the uni required for my placement supervisor. Then I had to find someone who was WILLING to take on a counselling student to work with clients who also had the needed quals. Needless to say that wasn’t going to happen in my area, I would have had to travel at least 3 hours in each direction, every day for 3 months.

So I transferred to a university that didn’t require me to do an internship to graduate with my Masters. But people tend not to take a Masters in Counselling seriously. They want a registered psychologist. Social workers here tend not to do counselling (not privately anyway, they might as part of the social work program they are funded to work in) and counsellors (and social workers) do not have to be registered to practice as such. (There is actually no peak body for counsellors. There are two that are vying for the position and the govt has said until they sort their shit out, they (the govt) doesn’t want to talk about regulating the industry. Social workers often have to be AASW eligible in order to get various positions etc but membership is not compulsory and there is no registration process for social workers or counsellors.

This article made my day! A couple of years ago I decided I wanted to become an RD, and maybe a degree is social work, and help people to eat “intutively.” I made the decision to go back to school and now I don’t know what the heck I’m doing. I’m learning about tube feedings and fluid requirements and how to run a food service operation and…I feel lost. This isn’t what I wanted to do at all. I’m starting to question whether I will actually be able to do what I set out to do or if I will be forced to spend my life figuring out how much protein someone with a stage II bedsore needs or planning menus for a nursing home. I’m not knocking anyone that does those things. It’s just not what I want to do. I guess I just don’t know how to get where I want to go.

Haha, this comment is so familiar to me! Although I did find it helpful to just throw myself into learning that stuff – I found out that I was surprisingly good at calculating TPN and EN requirements! And then I did spend some time helping to teach people to feed themselves through a G-J tube while they were going through cancer treatments. And I worked in food service – it wasn’t exactly fun, but I learned a lot and also got to directly help a lot of people in ways I never expected. There’s no greater joy than managing to somehow finagle a hamburger for some poor soul who’s been existing on random hospital food for weeks. And alllllllll those three-day food records. And learning about diabetes, helping to teach classes on carb-counting for insulin-pump users. Some fun, some not-so-fun. But much of it surprised me with how interesting it ended up being.

But yeah. This isn’t what I knew I wanted to do from the beginning – and I had a really strong idea of what I wanted to do. It wasn’t just a passing fancy – so feeling like one is being shoehorned into some role they really aren’t interested in can be frustrating.

While I was in school, I took every opportunity to do projects and write papers on health at every size, fat acceptance, etc. Because it helped me learn more about the thing I really had a passion for, and it kept me more engaged with school in general, but it also helped me to connect with those professors and faculty who were also into these topics. Turns out the chair of the nutrition dept. was really, really supportive of me and HAES, and so were at least three other professors. It was scary, but so worth it. I had some good conversations with fellow students about this stuff, too.

Overall, though, school was incredibly hard for me. Working, being married, living on one’s own (when some of my fellow students had parental support and few “adult” responsibilities, which made me sooooo jealous) made it really hard, in addition to having depression, and then developing super intense performance anxiety around school. I became such a perfectionist that the idea of studying, or writing a paper, or taking an exam filled me existential terror – my body responded as though every test of my ability were a life-or-death situation. I shook, I couldn’t sleep, I hated myself, I had to get sick notes and turn stuff in late, and I’m sure I completely exhausted the patience of all the faculty. It was ridiculous. Now that it’s over, I’m hoping my brain will heal after a while from the trauma. The weird thing was, at work I never had these problems – I was always an ace employee. I don’t know why all my anxiety was transferred to school.

Michelle, you have touched so many peoples’ lives, including my own in ways you might not even know. I’m a nutrition student in Maryland and on Sunday night I shared this site with a classmate. She emailed me the next day; the only thing she said to me was “I LOVE THIS WOMAN!”

I talk about your site to anyone who I think could benefit from your words and wisdom.

Please know that you truly have a gift for helping people navigate their relationships with food. That’s breathtaking.

When I see that you’ve written a new post, I stop whatever I am doing and immediately read it. I then scroll right back up to the top and read it again. And I’ll likely read it another time a week or two down the line. I drop everything to read your posts because what you are writing is so incredibly important to me. And because when I’m in the presence of greatness, I can’t help but stop and take notice.

Thank you for sharing your gift with me and all your other readers/clients. RD title be damned. :-)

It’s certainly not as bad. But that doesn’t mean it isn’t still privileging certain people over others purely due to their financial resources. It’s just further amplified in medicine and higher academia. Doesn’t make it ok.

Also, in most post-grad studies, there are chances of grants and financial aid and stipends. Not so in this situation. kthnxbye

Agreed 100% Michelle. Getting an internship was so stressful and I am very lucky to have been able to afford it. There are very few dietetic internships that pay you a stipend, and they are hard to get. And there are even fewer that offer financial aid unless you’re going to go on to get a Masters degree in nutrition or something else, which usually doesn’t increase your pay what-so-ever, so why would you spend another tens of thousands of dollars?

Michelle – I just found your blog, and I must say I love it. I understand your feelings toward the field of dietetics and becoming a dietitian… obviously from my name you can see that I am a registered dietitian.

BUT… I agree with so much of what you said in this post. It is a really tough field. And really all that I gained from my dietetic internship was experience in clinical nutrition. Sure I gained a lot more than that… but it’s something that I probably could have gained from the same experience YOU have.

I was very frustrated with the field when I started but I kept on pushing because that was “the right thing to do”. And realize that RDs sometimes feel the same way you do – because where I am at, many nutritionists with MUCH less experience and education than what you have are taking jobs that should be for more experienced, more trained individuals (what a RD should be!).

So, I want to just say that you’re awesome. I love the name of your blog and the content of your blog. I found it looking for “Marilyn Monroe’s body size” because I also have struggled with accepting my body size. I am also a “fat nutritionist” and you know what? I kinda love it now. I’m glad that you have been so sucessful without caving to the expectations of society the way I have – that you HAVE to be a registered dietitian to be successful.

So you know – I love Ellyn Satter as well, and I specialize in eating disorders as a dietitian. I teach the same thing you do – how to eat “normally”, mindfully, etc.

Sorry for my babble – I just read this and it really hit home for me. I’m glad there’s someone out here like you!

Awesome – so glad to hear from you, and have another piece of proof that there are RDs who get it. I’m constantly referring people to RDs trained in eating disorders because the work you do is so critically important, and because body acceptance is such a crucial part of it.

Also glad to have some encouragement from someone who’s gone through internship and made it through – so thank you for that :)

I’m not all that familiar with the world of dietetics so you should take what I say with a huge grain of salt (I’m a sociologist who knows a fair bit about the professionalization of the medical field ) — I would still urge you to consider doing the internship at some point, not only for the weight that the title carries but also because you can’t change the profession if you’re not part of it. It sounds like the certification process is really something that needs to change, and from what I know of you through your writing on the blog, I can see you being a real kick-*ss advocate for change!

Thanks Nicole, I really appreciate the encouragement – and I am still seriously considering it (if anyone would even accept me at this point, given all the shocking nutritional opinions I put on the internet!) I’ve got three years to decide, so I’ll be doing some research to figure out the best way of going about it. And I agree – it’s hard sometimes to change things from the outside.

Thank you so much for writing this. I am in Australia – supposedly a qualified Nutritionist but it’s not a qualification that is deemed good enough by those who are handing out jobs. To become a APD (accredited practising dietitian) I need to undertake more study which is only possible by quitting work and receiving no income for four years. Not possible with a mortgage! And because I can’t break into the industry, I can’t justify the costs of taking on any further professional development (a lot of which is not even available to me because I don’t have the right qualifications), so I am stuck in a bit of a vicious cycle here!

Like you I am not particularly interested in being a clinical dietitian – I did a brief stint in a hospital as a dietetic assistant and realised it was not my cup of tea at all. I am more interested in health promotion and helping people develop a healthy relationship with food, but this is an area that is hard to break into unless you have that APD after your name.

So I am glad to see that you have bucked the system and have made a career for yourself doing what you love – it is inspiring for me who is struggling to find a niche for myself.

I have to admit that I find it kind of funny how I’m considered qualified enough to work in a hospital, helping to educate patients about their therapeutic diets, carry out nutrition orders, and screen patients for assessment, but somehow not officially qualified to teach healthy, ambulatory people about Canada’s Food Guide. Something ain’t right.

I’m kinda happy my appointments have been no-shows this morning, because I am thrilled to find this blog! I too struggled through the hoops and now owe a ton of money in loans (compared to my expected income) for the privelege of writing RD after my name. I too was a non-traditional student, and even with the option of student loans, the burden of paying our bills still fell to my husband for year–plus we had to move in with my parents for a while (they claim they were happy to help).
The clinical dietitian I was trained to be has nothing to do with the wellness-whole-nutrition-for-health-and-happiness-RD I wanted to be. I’m still working toward becoming that RD, and in the mean time I’m working in public health, which is a happier medium than I expected to find. I respect the struggle my profession has for issues such as fair compensation and insurance reimbursement, but I also just don’t agree with most of the information I’m expected to regurgitate.
So my point is, thanks for being so honest with your struggles and quandries, and for making a safe place to share these struggles with others who also wonder what we’re really paying the ADA for, hand over fist (I gues now its the AND, but whatever). Oh, and thanks for giving nutrition advice that actually makes sense to normal people with cellulite and cravings. :)

Ooooh, they’re changing it to AND? I haven’t kept up. Thank you so much for reading and commenting. I love to hear from people who work in nutrition about what it’s been like for them. And I totally hear you – clinical dietetics is all about pathology, without much attention given to living well in general, it seems. I’m really interested in public health, and think that it can be a great power for good – so I’m glad to hear you’re there!

I can identify and completely hear your frustration as a Nutrition student in one of the accredited programs in Ontario.
Now is internship application time, and, as I’m sure you’ve experienced, hell for pretty much all of us… Looking at my fellow CLASSMATES as competition– the same classmates that stayed up to study for biochemistry, guided me through my organic chem labs– the ones I’ve grown to love and trust… “competition”… just a number really…

The stress, anxiety, bitterness, resentment is palpable. This is not what I signed up for.

I understand the frustration in finishing a course of study and then having to do a year long, unpaid internship because I am an RD. However, I can promise you that while I worked in the nutrition industry, in hospitals, government agencies and for profit businesses prior to completing my RD – there is SO MUCH additional knowledge that the internship provides. In fact, I would argue (and most RD’s would agree) that the learning curve is so steep during the internship that you come away wondering what you even learned while obtaining your degree. And further, the continuing education that an RD credidation requires is vital in ensuring complete knowledge and understanding in this ever changing field.

I’m not a fan of the ADA and currently not a member, but I do believe that RD is a necessary credential to ensure that accurate and safe information is being conveyed. I hate to see people act as if it’s not important or only two letters after your name. As you said, there are a lot of people out there writing “nutrition” books who don’t even have a background or education in nutrition, accredidation and the monitoring that goes along with it is how we seperate ourselves from everyone else.

Thanks Heather, I appreciate your input and encouragement. I still may go the internship route (or attempt to go that route, anyway), but I have a lot of mixed feelings about how the internship process works in Ontario.

I do feel strongly about accreditation, despite being an outsider at the moment.

Hello,
I came across your site while looking for something else and then realized we have a bit of a similar story. I also have completed an accredited dietetics course and even a masters in nutrition. I was unable to get the internships and, as a result, was not able to get registered. I have found I can do very little with my degree. I would be interested in learning how you were able to get nutrition related work while not being a dietitian. Feel free to email me!
colleen

I’m a huge fan of your site–it’s been incredibly helpful to me in learning to sort through my own eating issues.

I’m thinking seriously about studying/pursuing a career in nutrition, but it would be kind of a big career change so I’m looking for ways to get some beginning experience with and exposure to nutrition/dietetics work. If you have any suggestions for how to learn more or get some beginning work or volunteer experience, I would be so grateful!

I’m sorry I didn’t answer this before now – but if you contact some dietitians working at local hospitals, clinics, or in private practice, they might be interested in having a volunteer. If you have a specific area you’re interested in, like eating disorders or oncology, or whatever, that can help you to narrow it down. I used to volunteer at a local eating disorders support centre, doing front desk stuff and library stuff and taking out the garbage. At the hospital, I had plenty of volunteers coming through, and I got to train them to do 3-day food record assessments and whatnot. It really depends on what’s in your area.

I’m so glad to hear that someone else besides myself is in a similar situation. I just graduated in December with a degree in nutrition (dietetics) and have realized that I do not want to be a dietitian. I just want to help people learn to lead healthy lifestyles and be happy. I’ve tried working in a hospital and completely detested it, but I love nutrition and I love helping people. I feel your pain because I have found that my degree means nothing in the nutrition world without that internship and those two little letters. Apparently, all I am qualified to do is work for hospital or school cafeteria services. Yet someone with no education or experience in nutrition can counsel people as a “health/wellness coach” as long as they sell some nutritional supplements along with it (usually part of a pyramid scheme). I cannot be a part of something like that. It is so frustrating. If you have any words of wisdom for me, I would love to hear them! I wish you the best in your endeavors, Michelle, and your degree means something to me!

Apparently, all I am qualified to do is work for hospital or school cafeteria services. Yet someone with no education or experience in nutrition can counsel people as a “health/wellness coach” as long as they sell some nutritional supplements along with it (usually part of a pyramid scheme).

This is one of the things that bothers me the most. There is such a huge gap to be filled between these two extremes, and I don’t understand why it has to be so all-or-nothing. But currently that seems to be the way it’s set up. Personally I think there should be dietetics grads “coaching” or counseling average, healthy people in basic nutrition stuff, and helping them to navigate all the nutrition news in the media. Of course I’m biased because with my work experience I got to practice doing counseling, whereas another grad might not have, but it does seem a bit excessive to me that an internship is needed in order to teach average, healthy people about Canada’s Food Guide. It’s different if people are needing therapeutic diets, but for basic primary prevention/education? Come on. I mean, the nutrition component of my job basically consists of persuading people to eat regular meals, pay attention to hunger and fullness, and to eat multiple food groups. It’s not exactly radical or dangerous.

My school often did give talks on using your degree without an internship, and there are little niches people can put themselves. Personally, I would like to see more dietetics grads writing books about general healthy eating, to help at least add some scientifically-trained voices to the crazy milieu that is the diet section of the bookstore. I would like to see more dietetics grads writing columns about nutrition in papers or blogs. Mostly though, the niches suggested have been stuff like working in the food industry (I’m not really interested) or sometimes writing cookbooks (also not really interested, though I have nothing against cookbooks. I’m just not a very fancy cook.) Some people become professional home economists instead of RDs, though I don’t really know what all that entails. And then there’s the diet tech route, which in my experience, is basically just doing more hospital work, assisting dietitians. And of course, food service.

Since there isn’t a place readymade for people in our position, I guess we have to try and make one for ourselves. It’s not easy, but I think it’s worthwhile.

I feel that you denigrate the position of being a registered dietitian by stating that you are not an RD. There has been so much RD bashing lately and I am tired of defending my position and my qualifications. By stating that you are not an RD you hold yourself above what the rest of us are unjustly criticized for. I am weary of this type of lack of respect for a profession that strives to help others. I am not in bed with corporations and my opinions are not shaped by the corporate alliances that my professional organization makes (nor have I been told what positions I should hold). In fact I have been critical of the Academy of Nutrition and Dietetics’ corporate liaisons (I’m in the US). http://blog.fooducate.com/2010/10/17/ada-and-hershey-partnership-raises-questions-about-global-child-welfare/.

Like you, I was frustrated after receiving my undergraduate degree and I too felt that I was qualified for not much. I worked as a dietetic technician for three years before putting myself through the training necessary to become a registered dietitian. I have worked in hospital settings and had my passion for nutrition killed by this repetitive and unfulfilling work (for me). Fortunately, I have found my passion again through private practice and I can honestly see the value of my education in the people that I have had the privilege to help. I hope that you do go on to become an RD. We need more voices like yours in our profession. We’re a pretty cool group too, especially the forward thinking nutrition entrepreneurs (There is a professional group of nutrition entrepreneurs within the Academy. I think that you would get along well with us)!

I really don’t denigrate RDs at all, Carol. In fact I went out of my way to appreciate the RDs I have worked with and for. And in doing activism for Health at Every Size and size acceptance, I have many times been in the position of defending RDs and trying to break down stereotypes about them. I’m certainly not holding myself above anyone – I think you are reading a bit into what I’ve stated here, probably because, like you’ve said, you’ve been on the receiving end of some dietitian-bashing lately. That’s not at all what I’m doing here, and if anything, I consider myself to be junior to most dietitians – and that’s why I don’t do clinical nutrition as part of my job. I wouldn’t consider myself qualified.

My frustration is with the way that the process is set up in Ontario, and the wide gap I see between those who offer nutrition counseling with no credentials whatsoever, and those who have to jump enormous class-based hurdles in order to be RDs. There are well-educated qualified grads who could fill that gap, if there were a position for them.

My concerns about DC’s and ADA’s connections to weight loss and food industry concerns are the critique of someone who cares about dietetics, not someone who wants to dismantle it. I don’t think RDs are “in bed” with corporate concerns, but I do think there is a troubling LACK of questioning about these connections within the field. I’m glad you’re one who has stepped up to ask those questions – that’s part of why I’m involved in the critical dietetics movement.

I worked in clinical nutrition for two years, intimately with RDs, and trust me I have no wish to see them go away. But my frustration and concerns are valid, nevertheless. I appreciate your encouragement, and your pre-RD experience sounds similar to mine. In fact, I think we agree more than you might think. I still am seriously considering my options in doing an internship – whether it’s financially feasible for me will be another question altogether.

Thank you so much for sharing this post. I remember having a few classes with you in University and I’m so happy for you and your path right now. I was accepted in an internship here in Ontario last year and I dropped out a few months into it. I hated it. I survived the food service management rotation because I had a lot of experience in the area but once clinical started I couldn’t stand it. I realized that I really couldn’t see myself as any type of RD in any area. Yes, I’ve been asked why I didn’t pinpoint that before I even applied but you live and learn. I’ve left the dietetic profession and I’m embarking on a new path, I’m not sure where exactly I’m headed but I guess that’s what is making it exciting. I’m just happy to be relieved of the politics, tension and just all the bullshit. I’m out and I’m glad.

Hi Laura! Thank you so much for reading and commenting, and for telling me about your experience with internship. I think it’s impossible to really “know” whether you are going to feel a passion for clinical (or other) dietetics until you’ve been there, and perhaps it’s better to not go down a road that you know you won’t have a passion for – think how many people may have stuck through it just to finish, and ended up in careers where they were unfulfilled and unhappy. I wouldn’t wish that on anyone.

I’m sure your experiences in nutrition will give you an edge anywhere else you end up. Thank you again for being willing to talk frankly about your experience – I think it’s something probably a lot of people feel, but few people talk about. And it’s important.

The comment from Jennifer made me laugh. I am in a similar situation where I have a degree in dietetics and close to five years of experience in the field. I’ve worked in clinical settings, counseling settings and currently work for my state for the NSLP as a specialist. I never applied for an internship because the acceptance rate from my university went from 80% to 20% in the year that I graduated. Now, in my degree program we had to take statistics, and I knew that my odds dropped significantly that year. With the cost of applying alone costing over $300 in some cases with no guarantees, it wasn’t exactly sound reasoning at the time. I already had to work two jobs to get through my degree and minimize my debt, I’m not really sure where the internship money was supposed to come from.

I currently make a decent wage, actually more than a lot of clinical dietitians do, but I’m still considering doing an internship. The part that bothers me is…I graduated with plenty of students who didn’t deserve internships, who didn’t do as well in school and who I still consider to be slackers, but they are regarded as professionals and I’m not. I think that we should have an internship program but it should be part of the degree, similar to nursing. Nurses are medical professionals but don’t invest as much so they don’t have as much liability or get paid as much as doctors (at least in the US). Why can’t we get hands on training as part of the program and then be able to test. It makes the most sense.

Instead I’m faced with going through a slightly degrading and expensive process to become an RD, working under directors and managers who I currently advise working for the state. I have to forego my wages for a year AND spend money, to get paid maybe $2000 more a year. The return on investment in my situation is horrible and my reasons for doing it are future job security and professional respect…

Jennifer, I won’t even address how pathetically poor and unprofessional your writing style is, but I will say that I’m surprised that with all of the knowledge you must have gained in your internship that you didn’t take the time to think out the financial pros and cons behind Michelle doing an internship and make the obvious connection that it coulld be a financial disaster and possibly a horrible investment for where she currently is in her career.

Please in the future Jennifer, before you go calling people out, use some of your well paid for logic.

I appreciate your support. I almost feel like I need to re-write this post – it was written in a really emotional tone (heaven forbid!) and that seems to lead to people misinterpreting my message. And also, when people who live and work in places where the internship system isn’t broken like it is in Ontario, they are going to have a hard time understanding the angst.

I’m glad you can relate to what’s going on here, with the 20% acceptance rate. I don’t know what I’ll end up doing, but university didn’t exactly leave me rich beyond my wildest dreams. It’s going to be a serious sacrifice to go a year without income, and without any other financial support.

Hello,
I am a (newly) registered dietitian and I feel fairly similarly to you. I had to take out massive student loans to be able to afford my internship (so please don’t think it’s only for priveleged students). In fact, the majority of the other students in my internship class took out student loans and had to live extraordinarly frugal for a year. I’m a clinical dietitian and work in a neonatal ICU. I love the NICU and thought this was my dream job until I got here and realized the RD doesn’t mean much. You do all the work and put in the time and effort and doctors, nurses, pharmacists all think they can do your job. Basically, the credential doesn’t equal respect, not even by a long shot. I’m now looking into other avenues where I can still use my NICU nutrition knowledge because I truly do love the area. Possibly PA school or even med school. Anyway, back to the subject at hand. In my opinion, the internship is good for those who want to do clinical work because the hands on, standardized training is necessary and vital in the world of clinical nutrition. If that’s not the route you want to take, however, I believe the internship is a waste. Everything outside of my clinical rotations were things I could have simply learned ‘on the job’. And, honestly, someone with an RD who does nutrition counseling can spew out nutrition garbage just as easily as someone who does not have the RD. So, as long as you’re teaching sound nutrition knowledge, it shouldn’t matter whether you have an RD or not. Just my two cents:)

I feel your pain. I became an RD because I wanted to help people to eat whole, real healing foods to help them become and stay healthy. I was fortunate in that my parents paid for my masters/internship. But my God was it expensive and completely disillusioning. And then I graduated and realized that my salary may never exceed a year’s tuition in my masters program. Faced with low paying jobs, work I didn’t want to do, and a professional organization (ADA) that had sold its soul long ago to Big Food, I switched fields. I dropped my RD a few years later. It makes me sad that the field works this way.

For all of you out there who did not get an RD, well… don’t bother! the whole thing is a big scam! the labor practices in the field of Dietetics are deplorable: the whole “on-call” bull shit, you get called for half a day and given a full day load; the staffing style of hospitals: no official patient to dietitian ratio, they staff at bare minimum, and when census is high they pull people from the “on-call list”, the pathetic pay rate. So you get graduate level studies to work 2-3 part-time jobs with no benefits and to patch a 25K a year by working 3-4 full days a week or 5-6 half days a week, or such combination of odd hours. If you’re lucky 10 years down the line you may see some better job prospects; in what other field do you go through grad school to make less than an administrative assistant with a couple years experience? And the way these white females like to talk about their “passion”, “enthusiasm” and other mickey mouse bull shit –who is paying their bills, ‘ cause it ain’t them for sure?! I have been a big sucker to follow my stupid passion for nutrition! I have put myself through hell, yes, hell, in the dietetic internship, sleeping 3 hours at night for 11 months in a row, gaining 40#, because of stretching myself so hard top be perfect and do everything perfect (another thing dietitian are proud to claim they are “perfectionists”) –all this, for NO pay-off. And no, I am not just one sorry looser, talking bitter based on my own failed experience: I am looking at a span of 4 consecutive years of grads from the same internship program, and I count less than ten who have full-time jobs. The rest, patch together pathetic pay rates, and struggle to survive…many do have help from parents and/ or husbands –evidence that you cannot survive on the pathetic jobs you get in the glorious field of Dietetics. Kill your passion, follow your needs to self-support. Look at RN’s and their union, and then look at the pathetic passionate dietitians, unable to articulate anything else except positive crap, when the field continues to be dominated vastly by white females that are unable to fully support themselves. Shame on you, Dietetics, for treating your people this way; and shame on you, dietitians for not raising your voice. So, yeah… save your health and money and energy for better causes than getting a [redacted] R.D.! There is no respect for this title, and nobody has any idea how hard the long clinical hours are, and how sharp we need to be in pathophysiology and talking about labs with the M.D.’s and putting in rec’s for them –there is no awareness of the job R.D.’s do, so no satisfaction on that side either!

Wow, reading this post, the comments is depressing. I’m coming across alot of comments about RD career I didn’t see or hear when I was doing research. I graduated with a bachelor’s in 2009 but recently decided to go back to school to become an RD. I”m a year into it and looking at 2 1/2 years of DPD courses then the internship but I’m starting to question if I should even do it? I’m honestly not in it for the money (although I’d like to earn a decent living) but reading about crappy job prospects and satisfaction from people that have been in the field for years is extremely disconcerting and trust me, this isn’t the only place I’ve seen this. I now feel like I’m jumping into a black hole.

Hi deb – sorry this was a bummer for you. The situation may be very different in your area, so it would be a good idea for you to talk to some people near you who’ve actually gone through the process and know what it’s like before you get too discouraged. It may well be that you’ll be a good fit for this profession (obviously some people love it!) and have a smooth ride. I don’t want anyone to be discouraged from their path on the strength of this blog post and comments alone – this is just one side of the story.

However, I think it’s also good to have your eyes open while going through the process to become an RD, to know that there are potential obstacles that were perhaps not mentioned when you started. Had I known about the dismal scarcity of internship positions in my province (and make no mistake, the internship situation here is not merely “competitive” for the sake of quality, it is actually insufficient to meet the need of the number of nutrition grads AS WELL AS the number of dietitians who will be needed in the health care system in the very near future as the population ages), I would have chosen to do my undergrad elsewhere probably.

Hi there, I just came home from attending the yearly DC Dietetic Accredited Graduate Programs/Internship forum @ Mount Sinai Hospital and stumbled upon your post about not being a dietitian. I was stunned by how many people attended the forum and just got spooked at how competitive the internship process will be this year… the auditorium fits 204 students, and there were many students standing in the back row…I’m sure there’s more that just didn’t come. Thinking about it just shoots my nerves up and all together gives me a defeatist attitude.

I read your post and feel the same about the issues on the value of this degree. I will be graduating in October and it really sucks not being able to find work related to dietetics after putting so much effort into getting this degree… I did hear from one of my profs that there was some work trying to revamp the whole dietetics education/practice so that it would be combined in undergrad programs. But I think that failed?

I just want to say thank you for posting your feelings and thoughts about not being a dietitian. I’m sure there are many out there, like myself, who feel the same way.

After Googling “blog for students who quit their dietetic internship,” your link was the third or fourth return that popped up. Although I was actually in a DI, I quit in the homestretch (for a variety of reasons) and have had guilt over this for quite some time. I love nutrition, but do I not love practicing clinical nutrition. Thankfully, I am at a job where I can teach nutrition without the RD behind my name, but I feel people often think of me differently because those letters aren’t there. I realize our situations are somewhat different, but I want to thank you for voicing concerns for which I can certainly relate.

Thanks for commenting – it’s actually really nice to hear of someone in a situation where they can teach about nutrition without being a RD. Another commenter on this thread mentioned quitting her internship and it’s been really interesting to me to hear people’s stories. I wish people could talk more openly about it.

I know this post is a little old, but I stumbled across it and found it to be an interesting read.

I’m currently a nutriton student, but have the fortune of being in program with a fully integrated internship. I’ve enjoyed every minute of the program so far, and the girls that have just started their internship also seem to be thoroughly enjoying it. By the sounds of some of the comments, I guess we lucked out!

I think there is a lot of fear that comes with the term “nutritionist” due to it’s unregulated status – it’s understandable to a degree, but it’s definitely unfair when people automatically discredit it. Perhaps people should take a better look into someone’s background before judging them based on their chosen title. I would hope that at least being able to say you’re a B.Sc.Nutr, combined with your years of experience, holds some water.

We have had a few guest speakers in our classes who only have a B.Sc.Nutr because they never had integrated internships, and they are wonderful and knowledgeable people who work in places such as university student health services or for community programs. It’s great to see that they have made successful careers for themselves and it looks like you have too. Awesome!

On a slightly unrelated note, there was an entire session on HAES at the DC National Conference this year. I didn’t go to that particular session, but some of my friends did and they said it was very interesting! :)

Great post! I’m actually completing my final internship placement as a part of an integrated internship program. I consider myself lucky to get into the program, but I see a lot of parallels between the competitiveness of the admission into the internship program and the dietitian/nutritionist profession.

My other ‘intern’ friends and I found that we turned into, honestly, competitive and psychotic in the few years before we got into the program. And now that I’m out interning with dietitians I’m seeing that the cattiness and competitiveness doesn’t end once we get into internship. I imagine those types of attitudes are fostered by the female-centric profession that I’ve entered into. There’s a lot of comparisons made between who works harder than who and who gets so-and-so’s mat leave. I’m honestly finding it all to be a bit exhausting and I’m hoping that I can’t remove myself from that environment as much as possible (for my sanity!).

I’ve also had a few friends who completed the nutrition/dietetics degree with me and did not complete an internship. Most of those people have been working consistently for the past 6 months while I’m still an unpaid intern. Sometimes I find myself wondering if completing the internship program will even be worth it. I’m hoping that it will eventually, but I definitely understand why someone would skip out on the internship and just start off doing what they love!

Something that I also struggle with is the fact that I am also overweight, and how people or clients will perceive me as a dietitian. I thought that I would struggle more with it in my clinical role during internship as patients might be wondering ‘what is SHE doing giving me advice about nutrition?’ I recently stumbled on your blog and I think it gives a different perspective on the field of dietetics. Thanks for your honesty! :)

too funny! i’m actually in a similar boat! i have a double major in nutrition & food science and dietetics from a fantastic university in the U.S. but I never did an internship because there weren’t any even available in the state I lived in at the time I graduated … and there’s a lot of etc, but it’s a little long for a comment. I actually find myself just recently trying to get back in the game of working in the field of nutrition (I have been and still do stay home with my children for the past 7 years) and am coming up against many of your same frustrations. I so hear you. On so much of it. I hate that my knowledge is equated essentially with someone who took a weekend course on nutrition, or at least it may as well be because of the lack of those two letters. I get why having an RD license is important – just like you – but I just wish there were some middle ground for those with valid education to have some credibility instead of being lumped in with those who just thought one day that talking about nutrition would be a fun idea. I’m new to your blog, but I like the bits I’ve read so far.

I found this blog when searching for an explanation of why I was having a very rough time on my dietetics course. I was being bullied by lecturers, discriminated against, had learning material withheld from me, and a whole lot more. I’ve had dietetic students made vicious comments to me and about me. I’ve had all sorts of obstacles put in my way. Now “all” I have to do is the placements – I anticipate months of full-time, unpaid hell, being criticised by princesses. Why is this happening? Well, if you have a passion for nutrition and dare to follow that passion, but your BMI is not in the normal range, and you’re a mature age student, and a parent, you have to be very determined indeed to think that you might be able to join the ranks of the dietetic profession.

I would like to see a division of roles for dietitians – one branch for hospital work on wards – and another branch who work in the community, private practice, food service, out-patients, etc. I feel that the dietetic accreditation bodies are too stagnant in their thinking, not sufficiently promoting the important role that nutritionists/dietitians can play in the health of our citizens and are failing to protect the “good” from the “bitchy”. I could have trained to be a doctor, physiotherapist or other health professional in the same amount of time it’s taken to become a dietitian, and would have many more career options. I couldn’t recommend dietetics as a good choice to anyone (and I feel fairly confident that a lot of patients/clients feel the same way).

From your experience, do you (or anyone else here) have suggestions on how/where to look for nutrition positions and jobs that do NOT require the RD? I’m in the US.

I came at nutrition from a round-about background through a bachelors in biochemistry/molecular biology and some time spent in medical school. I am graduating from a Master’s program that does not include an internship (or even the certification requirements). My interest is in community nutrition. I have found that most of the non-RD positions posted through the school are for food service. To get an RD, I would require another year (minimum) of certification courses that I was NOT allowed to take while enrolled in the master’s program, then chance the application process for an internship (50% match where I live), and somehow support myself while remaining in debt from the education I have already accumulated.

It is sad to see that almost 15 years after I have graduated with a BS in Nutrition and Dietetics that the industry is still the same. I decided to not pursue an internship because they were so few and far between. I didn’t want to move far away from my husband just to get the RD behind my name. I, too, find my degree almost worthless. I can’t believe after so long it is still the same. I feel for all of you entering into the field now :) I guess some things will never change.

Very interesting to hear that you went through the same thing 15 years ago. Not exactly encouraging, but somehow kind of funny at the same time. It’s a lot of money (and time and effort) to spend for a degree that may or may not result in a career.

Hi, I think you really cover the truth and the “reality” Rds is going through, I am going to do my nutrition degree in UK next year. I want to be a RD next time specialising in Oncology or cardiology. Do you have any advices? I not sure whether if I need any specialisation to get to this niche field in dietics. To your understanding, what’s is the difference between a RD and a nutritionist? And the paying scale if say working in the hospital?

I am soo confused. Could all of you ONTARIANS ONLY, please help me figure out the best educational route for me. Please. I am a Personal Chef. I adore helping people and understanding REAL nutrition. I would like to return to school to help ensure that I have all the nutritional knowledge possible. There are several nutrition courses available but the science behind why, deeply interests me. I plan to create all meals wheat and dairy free but I need to learn the scientific FACTS. Do any of you have any suggestions for me. I have absolutely no desire to work in hospitals. I had scheduled a tour at UG but now I feel that perhaps I should simply just do an online certificate course.

Hi Chelsea – I wish I knew a better answer for you, but it might not be a bad idea to at least tour Guelph and talk with people there and see what it’s like. If you are just looking for nutritional knowledge and don’t want to practice on people or work in the hospital, but use it to inform your cooking, then you might be right – some kind of certificate or diploma program might be adequate to meet that need. Or you could always just do the dietetics degree knowing that you won’t bother with an internship, if you don’t intend to practice nutrition. The knowledge you get from the degree doesn’t evaporate into thin air if you don’t become a dietitian – you can just apply it to something else (like developing recipes.) Maybe other people here will have suggestions for you, but I think you might be best served by talking to the student advisor in the department you’re looking into applying for.

I’m not from Ontario, but I agree with Michelle’s idea of touring some more and perhaps pursuing a nutrition/dietetics degree and not worrying about the internship.

It also might be worthwhile to look into some kind of combined degree, like a major in nutrition with a minor in food science. I’m doing a nutrition degree right now but taking food science classes electives as well (e.g. dairy science, grain science, food additives, etc.) – it’s awesome and best of all, very interesting!

Yeah, food science would be great. The program at Ryerson had more of an emphasis on food science and product development than some other dietetics programs, if I’m remembering correctly. But it was still a fairly small component overall.

I stumbled onto your blog as I was typing in “Competition for dietetic internships”. I am currently applying for my dietetic internships with DC and it is my last year eligible to apply before I have to upgrade.

I agree with your views about how the RD credentialing works in Ontario. I feel discouraged to re-apply this year, even though i managed to build on my experiences and pursue graduate studies. Re-reading that stat about 80% of unsuccessful applicants just resonates in my head and makes me think, what’s the point. I was wondering if you have ever tried to reapply, even after gaining all those experiences from different fields, and how you decided clinical nutrition wasn’t for you. I spoke with a professor from Western and she told me that the people who are persistent in reapplying are usually the ones who are successful.

Hi Shay – to be honest, I have never applied for internship yet. I just graduated last year, and I really did not feel up to applying right away. It makes me very nervous, and I had some other projects I wanted to work on, but I am still considering whether or not to apply. I have experience and can probably get some reference letters from dietitians I have worked with, but I’ve also written a controversial blog that probably goes over like a lead balloon with DC. I may apply next year. Even after discovering that I can do other things than be a dietitian, part of me would like to be a RD so that I have a connection to ongoing developments and research in the field, but I’m not sure that dietetics will want me. I guess I’ll find out. I think it is probably true that persistence pays off.

Personally, I feel that with all the work you do and your dedication to the field, you have a good shot at it! You never know unless you try right?

Earlier this year, I was trying to think about my options of where I should apply, what routes I can take to get accredited, and I recalled this job fair I went to in Waterloo a few years ago. I spoke with a Dietitian who actually pursued her own internship. She actually discouraged taking that route, mainly because you have to meet certain competencies of an actual internship. I called the College of Dietitians of Ontario (CDO) about possibly pursuing this route, and I think the person I was talking to told me only 2 people succeeded in the past 10 years. The tough part about it is that you would have to document all your placements and get approval from hospital directors, insurance from different hospitals (if you did placements in different hospitals), and sometimes DC will ask for you to get more hours in a certain area – which can actually take more than a year. I know you said clinical is not top on your list, but it is an option – I would call it a last resort if someone really wanted to pursue the RD title.

Lastly, I read more comments about your post and there is a recurrent theme of being undervalued, or it might not have been what people thought it would been, or the investment was not worth the gain. It opened my eyes and really made me ask myself if this field was really for me.

Just wanted to say your post was really eye opening and it’s nice to know there are other careers you can pursue without the title. It kinda gave me hope! Keep up the good work :)

Thanks for the encouragement, Shay! I really appreciate it. I think nutrition students and grads are all in a similar boat, and it can be pretty scary. I have heard about self-directed internship, and I’ve casually thought it over, but like you said, it sounds like there is a ton of extra work involved for something that is already a pretty intense experience. I do know someone who went that route, and I think she also discouraged other people from doing it, haha! But you’re right, it is still an option, at least a last resort.

I noticed that theme of being undervalued, too, in other people’s comments on this post, and some of that actually surprised me and was very eye-opening for me as well. I know that lots of people in my position (either as undergrad students or waiting for an internship) feel left out in the cold, but I really did not expect to hear from current dietitians who feel that way. You kind of imagine, as a student, that once you’ve got your RD, you’ve “made it” and everything must be roses. Obviously, though, being a dietitian is a lot like any other thing, where some people find happiness and others don’t.

I think dietetics is a fascinating field, I think it has power to do so much good, and I feel a real affection for its history rooted in home economics and “woman’s work,” but I also think that it could use some new blood :)

I’m an undergrad in dietetics at McGill and internships are included in the program (we have 4 of them throughout the program). I have a lot of nutrition master students in my classes which is a bit strange since I’m gonna graduate having a bachelors in dt and they’ll have a ms in nutrition. We have to take a lot of random courses such as accounting and human ressources. I feel like we’re never prepared for our internships and the courses are not enough (a lot of reading on our own which I’m not complaining about, but it’s scary to be out there and feeling like you know nothing). Overall, I am not a fan of the program probably because I find the whole program structure… well.. stupid! And I’m not the only one. People are almost failling the courses this semester (fifth semester) everyone is giving their best and the results are just not satisfactory and since almost everyone is in the same situation I concluded that the whole structure of the program is not adequate. I’m trying to find some motivation but it’s getting harder and harder… :(

I’m sorry you’re having a rough time. I think students sometimes need extra support outside of what they get in mandatory classes. I hope you have a good support network with your fellow students and maybe even some professors you trust, who you can talk to. It can get very lonely feeling like you don’t know what you’re doing.

We also had to do accounting and human resources as requirements for DC. They were probably not things I would have taken on my own, for sure, but actually turned out to be kind of useful, so far anyway.

Hang in there and good luck. You can always come here to gripe if necessary…I’ve had a handful of nutrition students stop by, and I’m sure they can commiserate.

I think the problem is that it is kind of hard to get support from teachers. Some of them can be quite cold and when we have questions we often ask our TAs.. which ironically are in some of our dt classes.

How strict is McGill’s French requirement policy? As an anglophone, is there any chance I will survive in this program without a knowledge of French– would I be able to pick it up by second year (as required by the nutrition department)?

First of all let me tell you that we have a lot of international/anglophone students that do not speak French at all and they have no problem at McGill. Yes McGill does recommend you get some basic French knowledge by second year which will be helpful in your stage but every course is taught in English. It is always good to know French (especially if you want to work in Quebec afterwards) however if you only want to study here and then leave in another province it’s not really necessary/required for you to learn it. In that case for stage they will most likely place you in an English environment/hospital (of course you will always get French speaking patients to some extent but by then you would be able to learn some basic French, I am sure of that ;)).

I am! Well, I am considering it as mentioned by Michelle, it’s quite frustrating to be a dietetics student in Ontario (or anywhere else) without integrated programs!

I have been looking at McGill’s program, though I know you have mentioned it’s frustrating for yourself too because of the structure, I still am attracted to it because of the possibility to be accredited while learning.

But the French part scares me haha. Would a lot of extra studying be required to learn French? Or would just being in the culture for the year be enough? :s

Thanks again for your help! Hope you’re doing well with finals! :) (and thanks to Michelle for this blog– sorry if this has taken “comments” on a tangent!)

I just came across your “rant” while searching “can I practice nutrition without being certified” on google. I am currently a senior nutrition major at an accredited university in New Jersey and I should be apply for an internship within a few months but like you I am not sure if that is something I really want to do. It is sad that we go through all these years of education to then have to do a year long internship that costs an arm and a leg and who knows if you’ll even get accepted to one! between the cost, competitiveness, time, and overall politics of the internship I am seriously considering not even applying. I am glad to read a story about someone who is doing what they love without being an RD…good luck in everything that you do!

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So, this is my disclaimer. You alone are responsible for what you do with the information on this website. I'm not offering medical advice. I'm not a doctor. I'm not a registered dietitian. Any of the techniques and information I share with you are not a substitute for medical advice or treatment.